Gaële Lebeau1, Silla M Consoli2, Raphael Le Bouc3, Agnès Sola-Gazagnes4, Agnès Hartemann5, Dominique Simon6, Gerard Reach7, Jean-Jacques Altman8, Mathias Pessiglione9, Frédéric Limosin10, Cédric Lemogne10. 1. Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France; Inserm U894, Center for Psychiatry and Neuroscience, Paris, France; AP-HP, West Paris University Hospitals, Department of Psychiatry, Paris, France. Electronic address: gaele.lebeau@gmail.com. 2. Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France; AP-HP, West Paris University Hospitals, Department of Psychiatry, Paris, France. 3. Inserm U1127, CNRS U7225, Brain and Spine Institute, "Motivation, Brain and Behavior" Team, Pitié-Salpêtrière Hospital, Paris, France; Pierre and Marie Curie University, Paris, France; AP-HP, Neurology Department, Pitié-Salpêtrière Hospital, Paris, France. 4. AP-HP, Diabetology Department, Cochin Hospital, Paris, France. 5. Pierre and Marie Curie University, Paris, France; AP-HP, Diabetology Department, Pitié-Salpêtrière Hospital, Paris, France. 6. Pierre and Marie Curie University, Paris, France; AP-HP, Diabetology Department, Pitié-Salpêtrière Hospital, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Pitié Salpêtrière Hospital, Paris, France. 7. AP-HP, Endocrinology, Diabetology and Metabolic Diseases Department, Avicenne Hospital, Bobigny, France; Paris 13 University, Sorbonne Paris Cité, Bobigny, France. 8. Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France; AP-HP, West Paris University Hospitals, Diabetology Department, Paris, France. 9. Inserm U1127, CNRS U7225, Brain and Spine Institute, "Motivation, Brain and Behavior" Team, Pitié-Salpêtrière Hospital, Paris, France; Pierre and Marie Curie University, Paris, France. 10. Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France; Inserm U894, Center for Psychiatry and Neuroscience, Paris, France; AP-HP, West Paris University Hospitals, Department of Psychiatry, Paris, France.
Abstract
OBJECTIVE: Delay discounting is the tendency to prefer smaller, sooner rewards to larger, later ones. Poor adherence in type 2 diabetes could be partially explained by a discounted value of health, as a function of delay. Delay discounting can be described with a hyperbolic model characterized by a coefficient, k. The higher k, the less future consequences are taken into account when making decisions. This study aimed to determine whether k would be correlated with glycated hemoglobin and adherence in type 2 diabetes. METHODS: Ninety-three patients were recruited in two diabetology departments. Delay discounting coefficients were measured with a computerized task. HbA1c was recorded and adherence was assessed by questionnaires. Potential socio-demographic and clinical confounding factors were collected. RESULTS: There was a positive correlation between delay discounting of gains and HbA1c (r=0.242, P=0.023). This association remained significant after adjusting for potential confounding factors (F=4.807, P=0.031, η2=0.058). This association was partially mediated by adherence to medication (β=0.048, 95% CI [0.004-0.131]). CONCLUSIONS: Glycemic control is associated with delay discounting in patients suffering from type 2 diabetes. Should these findings be replicated with a prospective design, they could lead to new strategies to improve glycemic control among these patients.
OBJECTIVE: Delay discounting is the tendency to prefer smaller, sooner rewards to larger, later ones. Poor adherence in type 2 diabetes could be partially explained by a discounted value of health, as a function of delay. Delay discounting can be described with a hyperbolic model characterized by a coefficient, k. The higher k, the less future consequences are taken into account when making decisions. This study aimed to determine whether k would be correlated with glycated hemoglobin and adherence in type 2 diabetes. METHODS: Ninety-three patients were recruited in two diabetology departments. Delay discounting coefficients were measured with a computerized task. HbA1c was recorded and adherence was assessed by questionnaires. Potential socio-demographic and clinical confounding factors were collected. RESULTS: There was a positive correlation between delay discounting of gains and HbA1c (r=0.242, P=0.023). This association remained significant after adjusting for potential confounding factors (F=4.807, P=0.031, η2=0.058). This association was partially mediated by adherence to medication (β=0.048, 95% CI [0.004-0.131]). CONCLUSIONS: Glycemic control is associated with delay discounting in patients suffering from type 2 diabetes. Should these findings be replicated with a prospective design, they could lead to new strategies to improve glycemic control among these patients.
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